What is the normal Apixaban (Eliquis) dosing?

From the Guidelines

The normal dosing for apixaban (Eliquis) is 5 mg taken orally twice daily, but a reduced dose of 2.5 mg twice daily is recommended for patients who meet at least two of the following criteria: age 80 years or older, body weight 60 kg (132 lbs) or less, or serum creatinine 1.5 mg/dL or higher, as stated in the 2024 ESC guidelines for the management of atrial fibrillation 1.

Key Considerations

• The standard dose of 5 mg twice daily is recommended for most patients with atrial fibrillation.
• A reduced dose of 2.5 mg twice daily is recommended for patients who meet at least two of the specified criteria.
• The dose should be adjusted based on renal function, with a reduced dose recommended for patients with creatinine clearance 15-50 mL/min.

Conditions and Dosing

• For atrial fibrillation, the standard dose is 5 mg twice daily, with a reduced dose of 2.5 mg twice daily for patients who meet the specified criteria.
• For treatment of deep vein thrombosis (DVT) or pulmonary embolism (PE), the initial dose is 10 mg twice daily for the first 7 days, followed by 5 mg twice daily thereafter, as stated in the 2023 ACC/AHA/ACCP/HRS guideline for the diagnosis and management of atrial fibrillation 1.
• For DVT/PE prevention after hip or knee replacement surgery, the dose is 2.5 mg twice daily, starting 12-24 hours after surgery.

Important Notes

• Eliquis should be taken consistently at the same times each day with or without food.
• Missing doses can reduce the medication's effectiveness in preventing blood clots, while doubling up on doses increases bleeding risk.
• Patients should not stop taking Eliquis without consulting their healthcare provider as this could increase stroke or clot risk, as recommended by the 2020 ACC expert consensus decision pathway for anticoagulant and antiplatelet therapy in patients with atrial fibrillation or venous thromboembolism undergoing percutaneous coronary intervention or with atherosclerotic cardiovascular disease 1.

From the FDA Drug Label

2.1 Recommended Dose Reduction of Risk of Stroke and Systemic Embolism in Patients with Nonvalvular Atrial Fibrillation The recommended dose of apixaban tablets for most patients is 5 mg taken orally twice daily.

2.1 Prophylaxis of Deep Vein Thrombosis Following Hip or Knee Replacement Surgery The recommended dose of apixaban tablets is 2.5 mg taken orally twice daily.

2.1 Treatment of DVT and PE The recommended dose of apixaban tablets is 10 mg taken orally twice daily for the first 7 days of therapy. After 7 days, the recommended dose is 5 mg taken orally twice daily.

2.1 Reduction in the Risk of Recurrence of DVT and PE The recommended dose of apixaban tablets is 2.5 mg taken orally twice daily after at least 6 months of treatment for DVT or PE

The normal Elequis (apixaban) dosing is as follows:

• Reduction of Risk of Stroke and Systemic Embolism in Patients with Nonvalvular Atrial Fibrillation: 5 mg taken orally twice daily
• Prophylaxis of Deep Vein Thrombosis Following Hip or Knee Replacement Surgery: 2.5 mg taken orally twice daily
• Treatment of DVT and PE: 10 mg taken orally twice daily for the first 7 days, then 5 mg taken orally twice daily
• Reduction in the Risk of Recurrence of DVT and PE: 2.5 mg taken orally twice daily after at least 6 months of treatment for DVT or PE 2

From the Research

Normal Eliquis Dosing

The normal dosing for Eliquis (apixaban) is not explicitly stated in the provided studies. However, the following information can be gathered:

• Apixaban is used to treat or prevent thromboembolic events, and its dosing may vary depending on the patient's condition and renal function 3.
• The package insert for apixaban does not provide guidance for use in end-stage renal disease (ESRD), but studies suggest that it can be safely used in patients with ESRD 3.
• The safety and effectiveness of apixaban in patients with severe renal impairment have been evaluated in several studies, which suggest that it can be used with caution in these patients 4, 5.
• Some studies have compared the effectiveness and safety of apixaban with other anticoagulants, such as rivaroxaban and warfarin, in patients with atrial fibrillation and renal impairment 6, 4, 7.

Key Findings

• Apixaban has a favorable clinical efficacy and safety profile compared with vitamin K antagonists for patients with atrial fibrillation or venous thromboembolism and comorbid kidney impairment 5.
• The use of apixaban or rivaroxaban was significantly associated with reduced risks of all-cause death and gastrointestinal bleeding compared with warfarin in patients with stage 4-5 chronic kidney disease or on dialysis 4.
• No significant differences in the risks of stroke or systemic embolism and major bleeding were observed between apixaban and rivaroxaban in non-valvular atrial fibrillation patients with end-stage renal disease or receiving dialysis 7.

Dosing Considerations

• The dosing of apixaban may need to be adjusted in patients with severe renal impairment, but the exact dosing strategy is not specified in the provided studies 3, 5.
• Clinician experience and knowledge of patient-specific factors may be required in the management of comorbid patients with advanced chronic kidney disease or those requiring dialysis, as data on these patients are limited 5.